Opioid agonist treatments and heroin overdose deaths in Baltimore, maryland, 1995-2009

R.P. Schwartz, J. Gryczynski, K.E. O'Grady, J.M. Sharfstein, G. Warren, Y. Olsen, S.G. Mitchell and J.H. Jaffe

American Journal of Public Health, 2013, vol. 103, issue 5, 917-922

Abstract: Objectives: We examined the association between the expansion of methadone and buprenorphine treatment and the prevalence of heroin overdose deaths in Baltimore, Maryland from 1995 to 2009. Methods: We conducted a longitudinal time series analysis of archival data using linear regression with the Newey-West method to correct SEs for heteroscedasticity and autocorrelation, adjusting for average heroin purity. Results: Overdose deaths attributed to heroin ranged from a high of 312 in 1999 to a low of 106 in 2008. While mean heroin purity rose sharply (1995-1999), the increasing number of patients treated with methadone was not associated with a change in the number of overdose deaths, but starting in 2000 expansion of opioid agonist treatment was associated with a decline in overdose deaths. Adjusting for heroin purity and the number of methadone patients, there was a statistically significant inverse relationship between heroin overdose deaths and patients treated with buprenorphine (P =.002). Conclusions: Increased access to opioid agonist treatment was associated with a reduction in heroin overdose deaths. Implementing policies that support evidence-based medication treatment of opiate dependence may decrease heroin overdose deaths.

Keywords: buprenorphine; methadone; narcotic antagonist, article; drug overdose; heroin dependence; human; longitudinal study; mortality; opiate substitution treatment; statistical model; United States, Baltimore; Buprenorphine; Drug Overdose; Heroin Dependence; Humans; Linear Models; Longitudinal Studies; Methadone; Mortality; Narcotic Antagonists; Opiate Substitution Treatment (search for similar items in EconPapers)
Date: 2013
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Citations: View citations in EconPapers (3)

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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2012.301049_1

DOI: 10.2105/AJPH.2012.301049

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